‘Do you mean I’m not whole?’: Exploring the role of support in women’s experiences of mastectomy without reconstruction

Archer, Stephanie; Holland, Fiona G.; Montague, Jane

doi:10.1177/1359105316664135

Cited by 13 publications

(7 citation statements)

References 57 publications

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“…Women should be encouraged to explore their physical, emotional and spiritual well-being and the role BR may play for them 89. Throughout this process, by optimising the acceptability of the option of BR, women could select in an informed manner a treatment plan which may or may not include BR that best fits their desires and needs 89 91. Ensuring that patients and providers consider BR as an acceptable part of care for women with breast cancer will likely improve access to BR; future research is needed to evaluate this hypothesis.…”

Section: Discussionmentioning

confidence: 99%

How patient acceptability affects access to breast reconstruction: a qualitative study

et al. 2019

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ObjectivesThere has been limited research on the acceptability of breast reconstruction (BR) to breast cancer patients. We performed interviews to explore breast cancer patients’ acceptability of BR.DesignQualitative study.SettingRecruitment from six Ontario hospitals across the province (Toronto, Ottawa, Hamilton, London, Thunder Bay and Windsor) as well as key breast cancer organisations between November 2017 and June 2018.ParticipantsWomen of any age with a diagnosis of breast cancer planning to undergo or having undergone a mastectomy with or without BR.InterventionSixty-minute semi-structured interviews were analysed using qualitative descriptive methodology that draws on inductive thematic analysis.OutcomeIn the telephone interviews, participants discussed their experience with breast cancer and accessing BR, focusing on the acceptability of BR as a surgical option post-mastectomy.ResultsOf the 28 participants, 11 had undergone BR at the time of the interview, 5 at the time of mastectomy and 6 at a later date. Four inter-related themes were identified that reflected women’s evolving ideas about BR as they progressed through different stages of their disease and treatment. The themes we developed were: (1) cancer survival before BR, (2) the influence of physicians on BR acceptability, (3) patient’s shift to BR acceptance and (4) women’s need to justify BR. For many women, access to BR surgery became more salient over time, thus adding a temporal element to the existing access framework.ConclusionIn our study, women’s access to BR was negatively influenced by the poor acceptability of this surgical procedure. The acceptability of BR was a complex process taking place over time, from the moment of breast cancer diagnosis to BR consideration. BR access may be improved through enhancing patient acceptability of BR. We suggest adapting the current access to care frameworks by further developing the concept of acceptability.

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Section: Discussionmentioning

confidence: 99%

How patient acceptability affects access to breast reconstruction: a qualitative study

et al. 2019

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“…This may also be linked to sexual anxiety, specifically in relation to damaging the breasts, inflicting pain and/or concerns around causing the cancer to return during sexual intercourse (Marshall & Kiemle, ). Moreover, qualitative research suggests unconditional spousal support facilitates emotional intimacy following mastectomy without reconstruction (Archer, Holland, & Montague, ). Therefore, spousal reaction following breast reconstruction requires additional research to determine whether there is a need for sex therapy/psychosexual therapy for couples following reconstruction.…”

Section: Discussionmentioning

confidence: 99%

‘It's a silver lining’: A template analysis of satisfaction and quality of life following post‐mastectomy breast reconstruction

Matthews

Turner

Williamson

et al. 2018

British J Health Psychol

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This study provides new insights into post-mastectomy breast reconstruction and is a novel application of template analysis. The analysis demonstrates only slight variation in some categories of experience among women, despite a heterogeneous sample. The findings allow researchers and clinicians to focus on specific dimensions of satisfaction and quality of life to support the needs of women following reconstruction. Statement of contribution What is already known on this subject? Patient satisfaction and quality of life are key patient-reported outcomes of breast reconstruction, although relatively few studies distinguish between types of satisfaction. The number of women electing to undergo reconstructive surgery is steadily increasing. As a consequence, exploring patient-reported outcomes in reconstructive breast surgery has become increasingly important for research and clinical practice. It is often suggested that breast reconstruction offers psychosocial benefits, although within the literature some mixed findings have been reported. Therefore, a qualitative exploration has the potential to add some clarity to the experiences of women following post-mastectomy breast reconstruction. What does this study add? To our knowledge, this is the first study to employ template analysis to explore the experiences of women following post-mastectomy breast reconstruction. Template analysis demonstrated that there was only slight variation in some categories of experience among women, despite a heterogeneous sample. This study distinguishes between the patient-reported outcomes breast satisfaction and outcome satisfaction to identify the key factors that are involved in determining satisfaction. The findings allow researchers and clinicians to focus on specific dimensions of satisfaction and quality of life which require improvement to support the unmet needs of women following breast reconstruction. The study presents two novel findings. Women attributed the fear of cancer recurrence to no longer being able to have a mammogram on the affected breast(s). Women also reported a decline in appearance-related satisfaction over time due to either the ptotic nature of autologous-based reconstruction or the fuller projected breast implant-based reconstruction affords.

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“…Furthermore, spontaneous selfaffirmation (engaging in self-affirming thoughts in response to a threat) is positively related to psychological well-being (Emanuel et al, 2018). From a survivorship perspective, there are many potential threats to integrity of self and wellbeing, from initial diagnosis through treatments and transition to life post-treatment (Allen et al, 2009;Archer et al, 2018). Research examining the self-affirming capacity of expressive writing among early-stage breast cancer survivors showed that expressive writing was associated with fewer physical symptoms at follow-up (Creswell et al, 2007).…”

Section: Values and Self-affirmationmentioning

confidence: 99%

Values of cancer survivors and the supportive role of recreational video games

et al. 2019

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Value-affirming activities have been linked to positive health outcomes and improved ability to cope. For cancer survivors who regularly play video games, might the games have potential to affirm values? We surveyed gameplaying survivors and included an open-ended question asking about values and the extent to which they perceived gameplaying as supporting values. A content analysis of responses ( N = 533) using Schwartz’s value typology revealed that a majority perceived gameplaying as supporting values or offering other benefits. Self-transcendence followed by openness to change were the most frequently coded higher-order categories. The results contribute to a richer understanding of survivors who gameplay.

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‘Do you mean I’m not whole?’: Exploring the role of support in women’s experiences of mastectomy without reconstruction

Cited by 13 publications

References 57 publications

How patient acceptability affects access to breast reconstruction: a qualitative study

How patient acceptability affects access to breast reconstruction: a qualitative study

‘It's a silver lining’: A template analysis of satisfaction and quality of life following post‐mastectomy breast reconstruction

Values of cancer survivors and the supportive role of recreational video games

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